YNHH has approximately 20 nurses trained as Sexual Assault Forensic Examiners (SAFE). They provide care and support to sexual assault victims while collecting evidence that can be used in criminal cases. During Sexual Assault Awareness and Prevention Month in April, SAFE nurses make extra efforts to educate clinicians about the services they provide.
Emergency Department staff are used to dealing with all kinds of situations – from broken bones to heart attacks to major traumas.
But there’s one situation that can be daunting for even the most experienced healthcare professional: caring for patients who have been sexually assaulted.
“It’s not like coming to the ED with a cut finger.” said Lisa Graziano, RN, who works in Yale New Haven Hospital’s York Street Campus Adult Emergency Department. “What these patients have been through is so deeply personal.”
Graziano is one of about 20 YNHH nurses who specialize in caring for sexual assault patients. The nurses have undergone 40 hours of Sexual Assault Forensic Examiner (SAFE) training and are certified by the state Office of Victim Services. All but one work in the EDs at the York Street and Saint Raphael campuses and Shoreline Medical Center.
These nurses work with sexual assault victims 13 and older who agree to the SAFE process, providing supportive, nonjudgmental and confidential care. The nurses also conduct a medical/forensic exam using a 12-step evidence collection and documentation kit provided by the Office of Victim Services. The process of meticulously collecting and documenting statements and evidence can take four hours or more, and each SAFE nurse works with only that one patient.
Evidence collected is sent to state labs. While victims are not required to report assaults, the SAFE evidence can be used in future criminal investigations and court cases if they do. Last year, Erika Fiore, RN, Saint Raphael Campus ED, testified in court about evidence she’d collected eight years before.
“It makes you realize how important it is to document everything,” she said.
Going through the kit can be extremely stressful, which is why SAFE nurses ask patients at each step if they want to continue. Some patients do only a few steps; others complete the process.
“These patients have just had something taken away from them,” said Vanessa Dixon, RN, YSC Adult ED. “Letting them decide if they want to go through the next part of the SAFE process gives them control.”
“Giving them that control is part of the healing process,” added Carrie Bellemare, RN, YSC Adult ED.
For that and other reasons, being a SAFE nurse is rewarding, the nurses said. But it can take a toll. YNHH SAFE nurses worked with 129 patients in 2023 and 114 in 2024.
“I have so many stories in my head, sometimes I need a break,” Dixon said.
Marlea Bergeson, RN, said she “stepped away” from the program for a year and wasn’t sure she wanted to resume.
“One day one of my former patients recognized me and told me how much I had helped her,” she said. “Hearing that made me come back to the program. I thought, ‘OK. This is why I do it.’”
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